جودة الرعاية الصحية وسلامة المرضي (1- 100)

BMJ Qual Saf doi:10.1136/bmjqs.2010.049635
Original research
Alternatives to potentially inappropriate medications for use in e-prescribing software: triggers and treatment algorithms
OPEN ACCESS
Anne L Hume1, Brian J Quilliam1, Roberta Goldman2,3, Charles Eaton2,3, Kate L Lapane4
+ Author Affiliations

1Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
2Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island, USA
3Department of Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
4Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, Virginia, USA
Correspondence to
Kate L Lapane, Department of Epidemiology and Community Health, Virginia Commonwealth University, 830 East Main Street, Fifth Floor, Richmond, VA 23298, USA; kllapane@vcu.edu
Contributors All the authors listed made a substantial contribution to the following: conception and design, acquisition of data or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; final approval of the version published.

Accepted 31 May 2011
Published Online First 30 June 2011
Abstract
Objective To describe the development of evidence-based electronic prescribing (e-prescribing) triggers and treatment algorithms for potentially inappropriate medications (PIMs) for older adults.

Design Literature review, expert panel and focus group.

Setting Primary care with access to e-prescribing systems.

Participants Primary care physicians using e-prescribing systems receiving medication history.

Interventions Standardised treatment algorithms for clinicians attempting to prescribe PIMs for older patients.

Main outcome measure Development of 15 treatment algorithms suggesting alternative therapies.

Results Evidence-based treatment algorithms were well received by primary care physicians. Providing alternatives to PIMs would make it easier for physicians to change decisions at the point of prescribing.

Conclusion Prospectively identifying older persons receiving PIMs or with adherence issues and providing feasible interventions may prevent adverse drug events.